Identification of enteric pathogens in HIV-positive patients with diarrhoea in northern India

Enteric pathogens associated with chronic diarrhoea in HIV-positive patient s were studied. The study was conducted during January 1995-December 1998. Stool specimens from all diarrhoea patients (n=26) were examined microscopi cally for ova and parasites using wet preparations and stained smears. Stoo l samples from diarrhoea patients were also cultured on appropriate media t o isolate enteric bacterial pathogens, Of the 59 patients, 26 (44%) had pro longed diarrhoea for more than 4 weeks. Enteric pathogens were detected in 19 (73%) of the 26 patients: 17 patients harboured a single pathogen, and 2 patients had mixed pathogens. The detection rate of emerging parasites, in cluding Isospora, Cryptosporidium, Blastocystis hominis, and Strongyloides stercoralis as a single agent, was significantly higher than conventional p athogens (50% vs 19.2%; p<0.05). Only one patient harboured both convention al and emerging pathogens (Entamoeba histolytica and Cryptosporidium). Isos pora belli was detected in 8 (31%) of the 26 diarrhoea patients: in 7 (27%) patients as a single agent and in one patient with S. stercoralis. Cryptos poridium was identified in 3 (11%) diarrhoea patients: in 2 (8%) patients a s a single agent and in one patient with E. histolytica, followed by B. hom inis in 2 (8%) patients. E. histolytica was most commonly isolated (3/26; 1 1.5%), followed by Giardia lamblia, enteropathogenic Escherichia coli, and Campylobacter jejuni tone patient each), Parasitic pathogens were frequentl y associated with HIV-positive patients with diarrhoea in northern India. I . belli was the most frequent parasite isolated, followed by Cryptosporidiu m. Stools of all HIV-positive patients with diarrhoea should thoroughly be investigated to identify aetiologic agents for proper management.